Akantior (Polihexanide)

Akantior is employed as an ocular antiseptic in various clinical contexts where reduction of surface microorganisms is desired.

• Pre‑operative preparation of the ocular surface before cataract or intra‑ocular surgery.
• Prophylactic cleansing of the eye prior to intravitreal injections.
• Adjunctive treatment of superficial bacterial conjunctivitis or keratitis when a broad‑spectrum antiseptic is appropriate.
• Post‑operative irrigation after eye surgery to minimize infection risk.
• Disinfection of reusable ophthalmic instruments or contact lens cases under controlled conditions.
• Supportive hygiene for patients using ocular prostheses.

• Polihexanide, a polymeric biguanide, exerts its antimicrobial activity by interacting with microbial cell membranes. The positively charged molecules bind to negatively charged phospholipid components, causing disruption of membrane integrity, increased permeability, and leakage of intracellular contents. This leads to rapid loss of cellular viability and death of a broad range of bacteria, fungi, and some viruses on the ocular surface.

Adverse reactions to Akantior are generally limited to local ocular responses, although rare systemic effects have been reported.

Common

• Transient burning or stinging sensation upon instillation.
• Mild conjunctival redness or hyperemia.
• Temporary tearing or increased lacrimation.
• Slight foreign‑body sensation or itching.

Serious

• Allergic contact dermatitis of the eyelid or conjunctiva.
• Severe eye pain or photophobia persisting beyond application.
• Corneal epithelial defect or ulceration.
• Vision changes such as blurred vision or decreased acuity.
• Swelling of the eyelids (angioedema).

When using Akantior, certain precautions should be observed to ensure safety and optimal effectiveness.

• Do not use if the patient has a known hypersensitivity to polihexanide or other biguanides.
• Avoid application to a compromised corneal epithelium or active ulcer without medical supervision.
• Discontinue use and seek evaluation if persistent irritation or allergic signs develop.
• Keep the product out of reach of children and store according to manufacturer instructions.
• Use only the recommended volume; excess may increase discomfort.
• Inform healthcare providers of any ocular conditions or recent surgeries before use.
• Pregnancy and lactation status are not established; use with professional guidance.

Akantior may interact with other ophthalmic agents, and certain combinations should be avoided or used cautiously.

Avoid

• Concurrent use with other ocular antiseptics (e.g., povidone‑iodine, chlorhexidine) that may increase toxicity.
• Simultaneous administration with topical anesthetics that could mask irritation signs.
• Use together with contact lens solutions not compatible with biguanides.

Use with caution

• Co‑administration with prescription eye drops (antibiotics, steroids) may require timing adjustments.
• Patients receiving systemic immunosuppressive therapy may have altered healing responses.
• Use in eyes with recent surgery should be coordinated with the operating surgeon.
• Combination with ocular lubricants containing preservatives may increase discomfort.